Chronic diseases and health promotion

Part Three. What works: the evidence for action

Chapter Two. Review of effective interventions

Workplace interventions. Spotlight: USA

Workplace interventions for chronic disease prevention and control are a feasible and often successful means of improving the health of employed adults. Interventions tend to focus on chronic diseases and risk factors that substantially inhibit productivity and incur the most serious health and economic burdens.

Workplace interventions can lead to large gains, both in the short and long term, for employees and employers. Improvements can be seen in worker productivity, reduced levels of absenteeism, and employer cost-saving. These interventions have the added benefit of creating a workplace environment that is health-conscious, providing for easier follow-up with participants.

Programmes that address multiple risk factors for chronic diseases are more successful and improve participation. These programmes allow employees to decide what risk factors they want to improve and define their own goals.

Financial rewards, work-related incentives (counting programme time as part of core work hours, for example), discounts on fitness activities, or even simply providing programmes free of charge can increase participation in and adherence to workplace interventions. A comprehensive approach including both policies and programmes, rather than either in isolation, increases the likelihood that employees will participate. The most effective workplace tobacco control strategies have used comprehensive approaches, implementing tobacco bans as well as focusing on those at high risk.

Spotlight: Workplace health in the United States

Johnson & Johnson’s Health & Wellness Program seeks to reduce behavioural and psychosocial risk factors, increase healthy behaviours, detect disease early, and manage chronic diseases. The programme provides preventive services as well as services during and after a major medical event.

After almost three years, improvement was seen in eight out of 13 risk categories for employees. Risk reductions were significant for tobacco use, aerobic exercise, high blood pressure, high cholesterol, dietary fibre intake, seat-belt use, and drinking and driving habits. The programme also resulted in financial benefits to Johnson & Johnson in the amount of money saved per employee per year on medical expenses. These savings increased substantially after the second year.